title: Changing trends in symptomatology, diagnostics, stage and survival of prostate cancer in Northern Finland during a period of 20 years.
abstract: BACKGROUND
  Prostate cancer is the most common cancer among men in many countries. The aim of the present study was to find out how the symptoms leading to a diagnosis, diagnostic procedures and stages of the disease among prostate cancer patients have changed over a period of 20 years.
  
  
  METHODS
  This retrospective chart review consisted of 421 prostate cancer patients whose treatment was started in the years 1982, 1987, 1992, 1997 and 2002 at the Oulu University Hospital. Earlier prostatic disorders, specific urological symptoms, diagnostic procedures, the TNM classification and histological grade were recorded.
  
  
  RESULTS
  The number of symptom-free prostate cancer patients increased over the 20 years, as did the number of men suffering from chronic prostatitis, although the latter increase was not statistically significant. A drop in the number of clinical T4 cases and increase of clinical T1 and clinical T2 cases was recorded but no clear change in the histological distribution occurred. The 5-year prostate cancer-specific survival improved significantly over the 20 years. The urologist was found to be the person who was contacted first most often.
  
  
  CONCLUSIONS
  Our data indicate that the number of prostate cancer patients has increased hugely over the period from 1982 to 2002 and although the clinical T stage has moved towards earlier stages, the proportion of well differentiated cancers remains low, so that most patients have clinically significant cancer with the need of some form of therapy. Further, prostate cancer-specific survival improved significantly over the period.
authors.affiliation: Medical Research Center Oulu, Oulu, Finland. markku.vaarala@oulu.fi.
authors.forename: Outi T
authors.initials: OT
authors.lastname: Kavasmaa
authors.forename: Dimitri B
authors.initials: DB
authors.lastname: Tyomkin
authors.forename: Aare
authors.initials: A
authors.lastname: Mehik
authors.forename: Teija M
authors.initials: TM
authors.lastname: Parpala
authors.forename: Panu
authors.initials: P
authors.lastname: Tonttila
authors.forename: Ilkka
authors.initials: I
authors.lastname: Paananen
authors.forename: Pekka
authors.initials: P
authors.lastname: Kunelius
authors.forename: Markku H
authors.initials: MH
authors.lastname: Vaarala
authors.forename: Pasi
authors.initials: P
authors.lastname: Ohtonen
authors.forename: Pekka A
authors.initials: PA
authors.lastname: Hellström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors